Erlotinib-induced Perioral Lesions Resembling Scleroderma

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Erlotinib is an epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) used to treat solid tumors.
• Common dermatologic side effects of erlotinib include papulo-pustular acneiform rash and xerosis.
• A unique cutaneous reaction to erlotinib has not been previously reported.

Purpose of the Study:

• To describe a unique skin manifestation in a patient treated with erlotinib for non-small cell lung cancer.
• To investigate the potential causality between erlotinib and the observed perioral lesions.

Main Methods:

• Case report of a 68-year-old woman with metastatic lung adenocarcinoma treated with erlotinib.
• Clinical examination of perioral lesions, detailed patient history, and laboratory investigations.
• Assessment of causality using the Naranjo Adverse Drug Reaction Probability Scale.

Main Results:

• The patient developed perioral lesions resembling cuts and scleroderma, alongside typical acneiform rash and xerosis.
• Laboratory tests were within normal limits, ruling out other causes.
• The Naranjo scale indicated a probable causal relationship between erlotinib and the scleroderma-like lesions (score of 8).

Conclusions:

• Erlotinib can induce unique scleroderma-like perioral lesions, a previously unreported cutaneous side effect.
• Topical colloidal oatmeal lotion provided moderate improvement in skin lesions.
• Awareness of this reaction is crucial for patient management and avoiding unnecessary investigations.